MCI
by mcatB
Summary: A Mass Casualty Incident can the ER handle it? Nurse Carol's niece stars...


Dixie looked around the ER, carefully discerning the faces around her. Dr. Brackett had just called together all the doctors, nurses, interns and other staff of the ER.

"Okay, this is what we've got," he began. "The CHP just called us. They've had a multi-car pile-up on the 405. We're expecting at least 15 victims here. Mercy and Community Hospitals are getting just as many. According to paramedics on scene, we've got at least five criticals coming in by helicopter," he continued.

He paused to look over his staff, many of them facing the first Mass Casualty Incident of their careers. 

"I want everyone ready for this," he said. "Dixie's going to assign teams and trauma rooms. Anyone not designated to a particular team will be a floater, assisting when and where necessary." 

"How much time have we got until the first ones get here?" Dr. Sheila Williams asked.

Brackett looked down at his watch and answered, "About five minutes, so let's get started."

The flurry of activity began as the staff got their assignments and went about gathering and readying supplies for the incoming patients.

Dixie stood next to Sheila as they waited in the hall near the ambulance entrance.

"Is Johnny on duty today?" Dixie asked.

"No, it's his day off. We're having dinner at Aunt Carol's tonight, after I get off duty," Sheila replied.

Dixie was about to continue when the first ambulance arrived. The first patient in was a five-year-old girl.

"Five-year-old female, chest injuries, broken right tibia. Not wearing a seatbelt. Pressure's been dropping," the Craig Brice reported, pulling the gurney.

"Room Two," Dixie ordered.

Sheila looked sadly at the girl as she disappeared into the treatment room.

"Here's our patient," Dixie said, nudging her, getting her attention back on the present.

The paramedics started pulling the next patient out of the next ambulance. It was a man, strapped down to a backboard. Between the bandages, cervical collar, oxygen mask and strapping, it was hard to tell there was someone there at all.

"Thirty-year-old male, head and chest injuries. Possible C-spine damage. Pressure's been rising," Doug Bedoski said.

"Room Four," Dixie ordered, walking alongside the gurney as Sheila followed.

"He's been lapsing in and out of consciousness, but he hasn't been alert or oriented," Dougie Parsons added.

Sheila helped The Dougs lift the backboarded man off the gurney and transfer him to the treatment room's exam table.

"I want him typed and crossed," Sheila began. "And I want a full skull series ASAP. Do we know the kinetics?" she asked.

"His vehicle was found upside down. Looked like it rolled a few times," Doug replied, transferring the IV lines. "He was wearing a seatbelt," he added.

"What are his vitals?" Sheila asked, cutting away some of the red stained bandaging around the man's forehead so she could check his pupils.

"BP's 140 over 96. Pulse is 120. Respiration 20 and labored," Dixie answered.

Dixie looked up as she heard Sheila gasp. They both recognized their patient, now and looked at The Dougs, expectantly.

They both just shrugged, not knowing what to say.

"Oh, God," Sheila whispered, stepping back slightly.

Dixie was about to say something, to get the young doctor back on track, when she saw Sheila stop, take a deep breath and step forward toward her patient again.

"Johnny? Johnny, can you hear me?" Sheila called, a slight tremor in her voice as she pried open his eyelids. 

"I got another IV of Ringers started for you," Doug put in.

Sheila continued to call to Johnny as she also checked his ears and nose for cerebro-spinal fluid.

"Pupils are unequal and sluggish. I've got some CSF coming out of his right ear," she reported.

"Mmmmm," Johnny moaned beneath the oxygen mask.

"Johnny? Johnny?" Sheila called desperately. "Can you hear me? Are you with us?"

His eyes fluttered open, but did not focus. He did not reply to his girlfriend's voice.

"Breathing's becoming more labored," Dixie reported.

"Johnny, come on. Speak to me," Sheila coaxed.

"Lung's collapsed," Dixie added.

"Get a chest tube!" Sheila ordered.

"Respiratory arrest!" Dixie shouted.

"Bag him!" Sheila ordered, taking the chest tube kit out of Dixie's hands as Dixie grabbed the ambu-bag.

"V-Fib!" Dixie shouted, pulling the oxygen mask off of Johnny's face and replacing it with the ambu-bag.

Sheila pulled the defibrillator cart over and started to charge the paddles.

"Four hundred," she said, putting the gel onto the paddles. 

Dougie removed the straps and blankets from Johnny's chest.

"Clear!" Sheila shouted.

They watched as Johnny convulsed despite being strapped down to the backboard. Sheila saw the pattern on the monitor.

"Again! Clear!" she shouted before putting the paddles onto Johnny's chest again.

Again they watched their friend convulse. Again they saw the dismal pattern on the monitor.

"Again! Clear!" Sheila shouted again.

Once more Johnny convulsed within the confines of the backboard strapping. The monitor now showed a flat line, its constant hum echoed in the treatment room.

Sheila wanted to try again, but she saw the look in Dixie's eyes. It was over. She nodded solemnly and watched as The Dougs disconnected the equipment. Dixie drew the sheet over Johnny's still form.

"Come on," Dixie said quietly. "There are more patients coming in."

Several hours later, the staff held a debriefing in the hospital's conference room.

"Why did it have to be him?" Sheila asked Dr. Brackett. "Why'd I have to get him?" she asked angrily.

"Sheila, it was the luck of the draw. It wasn't done on purpose," he replied, trying to remain professional and not get defensive.

"I know that," she ceded, sighing loudly. "I know it could happen to anyone, any time. I just don't… I guess I just wasn't ready for it yet," she got out.

"Nobody is ever ready for something like that," Dixie added, patting the young doctor's knee.

"The important thing is that you kept your head and you did everything right," Dr. Brackett assured her.

"But he still died," Sheila responded. 

Then she glared at the figures sitting across the room.

"It's not our fault!" The Dougs cried out in unison, turning to stare at the man next to them, fixing the blame on him.

Sheila raised her eyebrows, questioning the man.

"Fine," he said sarcastically. "See if I volunteer to spend my day off helping you guys out again. Next time you have a mock-MCI drill, see if I show up," Johnny huffed, crossing his arms across his chest.

Authors' note – Okay, did I get you guys again? Don't you know I'd never kill off one of the guys? Or would I…….? ;p

"MCI" ©1999 Mady Bay. "Emergency!" and its characters © Mark VII Productions, Inc. All rights reserved. No infringement of any copyrights or trademarks is intended or should be inferred. This is a work of fiction, and any similarity to actual persons or events is purely coincidental. 

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